Provider Demographics
NPI:1467653881
Name:PRAFF, NADAV JACOB
Entity Type:Individual
Prefix:DR
First Name:NADAV
Middle Name:JACOB
Last Name:PRAFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5201
Mailing Address - Country:US
Mailing Address - Phone:845-352-4300
Mailing Address - Fax:845-352-4302
Practice Address - Street 1:78 LAFAYETTE AVE STE 203
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5551
Practice Address - Country:US
Practice Address - Phone:845-352-4300
Practice Address - Fax:845-352-4302
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019131011223G0001X
NY048949-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice